INDIVIDUALIZED APPROACH TO PATIENTS WITH PULMONARY FIBROSIS: A REVIEW OF CURRENT INTERNATIONAL GUIDANCE

Abstract In patients with pulmonary fibrosis (PF), disease course, treatment response and quality of life differ sharply, so a single "standard" regimen is not enough. This review summarizes the 2022 ATS/ERS/JRS/ALAT recommendations on idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF), data on nerandomilast, approved in 2025, and models of patient-centered care. The individualized approach has five components: (1) precise phenotyping based on multidisciplinary discussion; (2) drug selection that takes into account the patient's goals, comorbidities and tolerability; (3) pulmonary rehabilitation, oxygen and nutritional support; (4) management of symptoms (cough, dyspnea, anxiety); and (5) introduction of palliative care and advance care planning from the early stages of the disease. The review offers clinicians a practical algorithm and identifies unresolved questions. Keywords: idiopathic pulmonary fibrosis; progressive pulmonary fibrosis; individualized approach; patient-centered care; antifibrotic therapy; palliative care.